perforated peptic ulcer 穿孔した胃潰瘍
Kjetil Søreide1, Kenneth Thorsen2, Ewen M Harrison3
1Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Lancet (London, England)
|October 14, 2015
まとめ
穿孔性胃潰瘍の治療には早期の手術と症のコントロールが必要です. 臨床的意思決定を改善し,この一般的な緊急事態における高い死亡率を減らすために,より質の高い試験が必要です.
科学分野:
- 胃腸内科
- 緊急 医療
- 手術 研究
背景:
- 穿孔性胃潰瘍 (PPU) は,最大30%の死亡率を持つ世界的な緊急事態です.
- 限られた高品質の研究は,PPUの最適な臨床意思決定を妨げています.
- 人口統計と病因学的差異が世界的に存在し,PPUの結果に影響を与えています.
研究 の 目的:
- 穿孔性胃潰瘍の管理に関する現在の証拠を要約します.
- PPUにおける臨床試験における 研究のギャップと将来の方向性を特定する.
主な方法:
- PPUに関する入手可能なランダム化試験と出版された文献のレビュー.
- PPUの人口統計,原因,死亡率に影響を与える要因の分析
- 外科的および非外科的アプローチを含む現在の管理戦略の評価
主要な成果:
- 早期の手術 (腹腔鏡または開いた修復) と毒症の管理は,PPUにとって極めて重要です.
- 非手術的および内視的アプローチは有望ですが,さらなる試験の検証が必要です.
- 臨床予測の規則の正確性は変化し,改善された証拠が必要である.
結論:
- 高品質で偏差が少ない試験が緊急に必要であり,PPU管理の証拠を進める必要があります.
- 術後のモニタリングの最適化に重点を置くべきです.
- PPUの治療を世界的に標準化するには 確固たる臨床試験データが必要です
関連する概念動画
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